You should be measuring return on investment (ROI) for every marketing strategy or channel you use. To accurately measure ROI, you’ll need one very important number…the “case average” of your new patients.

Case average is a figure that represents how much money a patient will generate over time in your practice. You will sometimes hear it referred to as “lifetime value of a patient.”

You figure it by taking your collections for the month (or quarter, year) and dividing by the number of new patients during the month. And make sure to count all the new patients who’ve come into your practice, not the number of patients who started care. (I do exclude freebies who never get an exam though.)

You can also calculate a case average using a different forumla. Take your PVA (patient visit average) and multiply it by your $ collect per visit. So if your PVA in your office is 22 and you collect an average of $50 per visit, then your case average is around $1100 (which is too low.) But I don’t like this method as much because it can be inaccurate, since you’re figuring an average from averages (that have usually been rounded up or down).

Some chiropractors don’t like to calculate case averages in their office, because they think you’re putting a dollar value on the patient’s head. But let’s face it, you’re running a business here. There are two parts to running your own practice… a clinical aspect and a business aspect. This blog is about the business aspect.

The biggest reason to determine case average in your practice is to make good marketing decisions. Combine it with your conversion rate and you can really drill down on your marketing. Let’s run through an example…

An ad costs you $1500 to run. The last two times you ran it you got 13 new patients. You’re thinking about running it again, but your not sure if its really worth it. Because you’ve read this blog for awhile now, you’ve been keeping track of your numbers (right?). You know that every new patient that walks in the door will equal an average case of $1500. And you know that if a new patient comes in, you have a history of converting about 60% of them to care.

So if the ad produces 13 new patients, you’re going to convert 8 of them (13 x .60 = 7.8 rounded up).
8 new patients times $1500 case average is $12,000.

So now back to the question. Should you spend $1,300 on an ad to get $12,000 in return? If you said “NO, $1300 for one ad is crazy!”, you need to go back and reread the above paragraph until you get a yes.

This is the problem with judging your marketing solely on the number of new patients. Some chiropractors think…”13 new patients, well gosh Dr.. Beck, that’s not very many. Dr. Joe Blow said he got 187 new patients from an ad!”

That’s great for Dr. Joe. But I wonder what his conversion percentage is? And what?s his case average? Because if he really did get 187 new patients and converted most of them, he’s got a million dollar a year practice.

In today’s world, you need a case average well over $1500 to be profitable in practice. If this number gets below $1000 your usually going to struggle unless you have a ton of new patients coming the door. If the case average falls below $500 for more than a month, you?re practice is in big trouble.

The best way to get a higher case average is to increase your retention and collect more per visit.

Also, you can raise your case average by planning out each patient’s case in detail. This means around the time you do your report of findings with the patient, plan the services you’ll be performing with care plan. For example, if you are going to see a patient for 24 visits, what are all the services and billing codes you’ll be performing. Use a travel card, folder or software to keep track of this.
Planning the case out like this also helps your staff stay on track with the patient?s care. If a re-exam is supposed to take place on visit 12, your staff sees it and is able to make sure it gets done and billed. Or if an extremity adjustment is supposed to be done each visit, you are reminded of it.

This may sound like a simple step to take, but don’t overlook the pre-planning of a patients care. You’ll be surprised at how much you and your staff miss if you’re not watching it every day on every patient. Just one small service missed regularly can amount to hundreds of dollars on each case.

I once counted up how much revenue was lost one month because my staff had “missed” a few re-exams, extremity adjustments, re-xrays, computerized test-ing, home exercises, rehab etc. It came out to be over $3,000. From that point forward, I made sure everyone (including myself) kept up with each patient’s planned care.

Each month, figure your case average for your practice. Then check to see how your marketing is going. The number of new patients you get is important, but make sure you are considering the total dollars they are bringing into your business as well.

Have you ever thought about how patients think?

When I first started out in practice, I didn’t really care what patients thought about their health problems. I was the doctor, and I was just going to tell them the “truth” about what was going on and how to fix it.

You can imagine how many patients I “turned off” by doing this.

I’ll never forget what a new patient taught me regarding this attitude.

I was just finishing up the new patient exam and x-rays, when she asked “Well Doc, do you think you can help me?”

I said “Mrs Smith, we’ve had great success with other patients that have had…” and I went on to list many of the problems chiropractic can help with. I think I even mentioned a few of the testimonials in the books we had around the office, and handed her one to look at. I was in a hurry and had the patients stacking up out front.

That’s when she looked at me angrily, and said “Dr. Beck, that’s not what I asked. I asked if you could help me with my problem?”

That’s when it hit me…

Patients want help with their problems! They want to believe you can help them, before they even come in to see you.

They aren’t interested in the history and philosophy of chiropractic.

They don’t care about all the problems you can help or who you’ve helped before them.

I have remembered this lesson every since. She was almost furious that I wasn’t addressing her problem directly. That’s the one question all patients want to know. That’s why the come in to see you!

Now obviously I couldn’t guarantee her I could help her problem. But I could have been more specific about the successes we had with her exact condition in the past. And I could have reassured her that if anyone was capable of helping her, we had the best chances of doing that.

How does this relate to marketing?

Marketing is teaching, telling, showing, persuading people to use your services over anyone else’s. And the best marketing message is one that’s relevant to your prospects.

People are searching for answers to their problems in life. They want a doctor who can help them and they will respond to marketing message that appears customized to them.

You can go on and on about chiropractic, but all they want to know is how you can help them. They want to know “what’s in it for me” (WIIFM). And we can’t assume every potential new patient knows what chiropractic is or how it can help them. Most Don’t!

So when marketing your practice, be sure that you are speaking directly to the person’s problems. Make them believe you are the one that can help. Whether it’s on your website, landing page, newspaper ad, yellow pages, or even on your business card.

For chiropractors with conversion problems, this one thing can make a huge impact. The more specific your marketing is, the more credibility and proof you build to that new patient. So that when they do come in, they are less likely to question your recommendations.

P.S. This of course does not negate using testimonials. It prooves the point you need to make your testimonials specific to the target patient you are marketing too. More on this in a later blog post…